Evaluating perceptions, comprehension, and awareness of anabolic androgenic steroid use among gym users in the Riyadh region of Saudi Arabia

A BSTRACT Background: Despite their clinical benefits, people frequently misuse anabolic-androgenic steroids (AAS), synthetic testosterone derivatives, for performance enhancement, but their illicit use poses serious health risks. Objective: This study aimed to evaluate the prevalence, patterns, and awareness of AAS use among male gym attendees in Riyadh, Saudi Arabia, and compare these findings with a non-gym user control group. Methods: A descriptive cross-sectional study was conducted from August 2024 to January 2025, involving 466 male participants aged 16 years and above. Data were collected via an online questionnaire distributed through social media platforms. The questionnaire assessed demographic information, awareness of AAS, and attitudes toward its use. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) and R, with Chi-square tests and t-tests used to evaluate associations and differences between groups. Results: The study revealed that 31.33% of participants reported AAS use, with gym members showing a significantly higher prevalence (43.6%) compared to non-members (12.5%). Younger individuals (20–24 years) and those in the sports field had the highest prevalence of use (38.6% and 65.5%, respectively). The primary motivation for AAS use was muscle building (84.8%), with Anavar and Deca-durabolin being the most commonly used steroids. While 81.5% of users were aware of the general risks of AAS, awareness of specific complications, such as exacerbation of pre-existing conditions, was lower (58.9%). The Internet ( n = 302) and friends ( n = 220) were the most common sources of information about AAS. Conclusion: The high prevalence of AAS misuse among gym users in Riyadh calls for targeted public health interventions, educational campaigns, and stricter regulations to promote public health and youth well-being.